The immune system in 40 aplastic anemia patients receiving conventional therapy

Abstract

Forty patients with aplastic anemia who were being considered for bone marrow transplantation were studied by in vivo and in vitro techniques to determine if the immune system in aplastic anemia is generally affected. It was found that patients with aplastic anemia had mild lymphopenia. with levels of circulating thymus-derived and bone-marrow-derived cells that were apparently secondarily depressed. Marked monocytopenia was observed. but this finding was mitigated by recovery of essentially normal numbers of mononuclear phagocytic cells (using a discontinuous Hypaque-Ficoll density gradient) and by the ability of patient mononuclear cells to participate at least as well as control cells geneic unrelated cells. Clinically the patients did not suffer from fungal or protozoal infections, which are common in immune deficiency syndromes. Thus these aplastic anemia patients were little different from normal subjects. The mild lymphopenia. impaired delayed hypersensitivity. and modestly depressed lgG and lgM levels were correlated with corticosteroid therapy.

Lymphocyte subsets in patients with aplastic anemia

“…Our observation of a low number of T-cells in patients who have shown a good response to treatment is the only significant laboratory correlation with clinical status in this selected group of patients. Previous authors have shown that patients with AA may have absolute, but not relative, T-cell lymphopenia using rosetting methods [21]. Using monoclonal antibodies, we have found both absolute and relative T-cell lymphopenia in 12 and 8 out of 31 patients, respectively (39% and 26%), and this T-cell lymphopenia correlated to a good response to treatment.…”

“…The depressed proliferation to PWM found in some patients (7 out of 18) has been previously reported in patients with AA [21]. Neither these authors nor ourselves observed hyporesponsiveness to PHA or Con-A.…”

Análise da rejeição nos pacientes transplantados por anemia aplástica severa condicionados com ciclofosfamida ou a associação desta ao bussulfano

“…32 O corticóide inibe a imunidade celular e humoral nos pacientes com AA e a pega pode ser facilitada por este mecanismo. 33 Os pacientes com falha primária de pega estão associados a um pior prognóstico. No Hospital de Clínicas, sete pacientes não tiveram evidência de pega e, dentre estes, somente um sobreviveu ao segundo TMO.…”

Peripheral blood lymphocyte numbers, lymphocyte proliferative responses in vitro, and serum immunoglobulins in regular hemapheresis donors

“…PHA; concanavalin A, CON-A; and pokeweed mitogen, PWM), soluble antigens (staphylococcal filtrate, candida, and streptococcal varidase): and cellbound alloantigens (mixed lymphocyte culture. MLC) [18]. Results are expressed as net counts per minute (cpm).…”